Provider Demographics
NPI:1447148788
Name:HERNANDEZ, JAVIER (RBT)
Entity type:Individual
Prefix:
First Name:JAVIER
Middle Name:
Last Name:HERNANDEZ
Suffix:
Gender:M
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 NE 24TH AVE
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33909-1717
Mailing Address - Country:US
Mailing Address - Phone:239-314-8044
Mailing Address - Fax:
Practice Address - Street 1:1500 NE 24TH AVE
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33909-1717
Practice Address - Country:US
Practice Address - Phone:239-314-8044
Practice Address - Fax:239-314-8044
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-25
Last Update Date:2025-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLBACB1335742106E00000X
FLRBT25448030106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst